Provider Demographics
NPI:1811104391
Name:EATON, JULIA ANN (RPH)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:ANN
Last Name:EATON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 RUTLAND SHOPPING PLZ
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-5201
Mailing Address - Country:US
Mailing Address - Phone:802-773-1600
Mailing Address - Fax:
Practice Address - Street 1:1 RUTLAND SHOPPING PLZ
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-5201
Practice Address - Country:US
Practice Address - Phone:802-773-1600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT033-0003138183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist